Saleh Rachidi1, Kristin Wallace2, Hong Li2, Tim Lautenschlaeger3, Zihai Li4. 1. Department of Dermatology, Johns Hopkins Medicine, Baltimore, Maryland. Electronic address: salehrachidi@gmail.com. 2. Department of Public Health Sciences, Medical University of South Carolina, Charleston, South Carolina. 3. Department of Radiation Oncology, Indiana University Health, Indianapolis, Indiana. 4. Department of Microbiology and Immunology, Medical University of South Carolina, Charleston, South Carolina.
Abstract
BACKGROUND: Mouse studies show that tumor-derived prostaglandins and platelets promote melanoma progression and immune evasion. OBJECTIVE: Determine whether aspirin confers longer survival in patients with melanoma. METHODS: A retrospective cohort study of 1522 patients at Indiana University Health who had melanoma diagnosed between 2000 and 2014 and were followed up through September 2016. RESULTS: Aspirin use was associated with longer overall survival in univariate analysis and after controlling for age, sex, stage, and treatment modalities (hazard ratio [HR], 0.58; 95% confidence interval [CI], 0.45-0.75). Aspirin use was not associated with survival in patients with in situ and stage I melanoma but was associated with better survival in stages II (HR, 0.45; 95% CI, 0.24-0.82) and III (HR, 0.57; 95% CI; 0.34-0.96). No statistical significance was observed in stage IV patients (HR, 0.55; 95% CI, 0.27-1.13). In turn, melanoma in patients using aspirin before diagnosis was less likely to be diagnosed in stages III or IV. LIMITATIONS: Observational study. CONCLUSIONS: Aspirin could provide a survival advantage in melanoma. Clinical trials investigating the therapeutic potential of aspirin are warranted.
BACKGROUND:Mouse studies show that tumor-derived prostaglandins and platelets promote melanoma progression and immune evasion. OBJECTIVE: Determine whether aspirin confers longer survival in patients with melanoma. METHODS: A retrospective cohort study of 1522 patients at Indiana University Health who had melanoma diagnosed between 2000 and 2014 and were followed up through September 2016. RESULTS:Aspirin use was associated with longer overall survival in univariate analysis and after controlling for age, sex, stage, and treatment modalities (hazard ratio [HR], 0.58; 95% confidence interval [CI], 0.45-0.75). Aspirin use was not associated with survival in patients with in situ and stage I melanoma but was associated with better survival in stages II (HR, 0.45; 95% CI, 0.24-0.82) and III (HR, 0.57; 95% CI; 0.34-0.96). No statistical significance was observed in stage IV patients (HR, 0.55; 95% CI, 0.27-1.13). In turn, melanoma in patients using aspirin before diagnosis was less likely to be diagnosed in stages III or IV. LIMITATIONS: Observational study. CONCLUSIONS:Aspirin could provide a survival advantage in melanoma. Clinical trials investigating the therapeutic potential of aspirin are warranted.
Authors: Heather S Feigelson; John D Powers; Mayanka Kumar; Nikki M Carroll; Arun Pathy; Debra P Ritzwoller Journal: Cancer Med Date: 2019-06-19 Impact factor: 4.452